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Hooking Psychotherapy Patients

What keeps a psychotherapy patient coming back?

Psychotherapy promises to treat, or at least to help, a mental illness, but few improve by the end of the first session. How long will a patient want to continue without seeing results, unless the psychotherapist “hooks” them in some other way?

What role does money play? If the patient’s insurance reimburses or someone else pays the psychotherapist, what would prevent you from returning to talk with someone who seems to understand you. Some psychotherapists believe that the patient will feel more invested in the treatment if they must pay at least part of the fee, but a relatively high fee may mean little to a wealthy individual and even a low fee may burden a poor person.

I suspect most training in psychotherapy includes, either implicitly or explicitly, some attention to giving the patient something that makes them want to hang in there until they see results. Examples:

  • Validation

  • Praise

  • Respect

  • Understanding

  • Romantic connection

  • Support

  • Alliance

  • Feeling liked

This all begs the question of how much of those sessions actually consists of treatment as opposed to motivating the patient to keep coming back for more, especially when other people’s money (e.g. insurance) foots the bill. To what extent do professional ethics allow for hooking the patient?

What tactics have you employed to keep patients in psychotherapy?

Have you ever felt like your psychotherapist tried to keep you hooked in psychotherapy?

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